| Leila Peterson, Pllc | |
| 
					2680 S Val Vista Dr Ste 140 Gilbert AZ 85295-1621  | |
| (435) 757-8824 | |
| Not Available | 
| Full Name | Leila Peterson, Pllc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 2680 S Val Vista Dr Ste 140, Gilbert, Arizona | 
| Authorized Official Name and Position | Leila Peterson (OWNER) | 
| Authorized Official Contact | 4357578824 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Leila Peterson, Pllc 2680 S Val Vista Dr Ste 140 Gilbert AZ 85295-1621 Ph: () -  | Leila Peterson, Pllc 2680 S Val Vista Dr Ste 140 Gilbert AZ 85295-1621 Ph: (435) 757-8824  | 
| NPI Number | 1700413978 | 
|---|---|
| Provider Enumeration Date | 03/26/2020 | 
| Last Update Date | 06/25/2020 | 
| Medicare PECOS PAC ID | 5890126908 | 
|---|---|
| Medicare Enrollment ID | O20200505001776 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1700413978 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Leila King Peterson | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1952535056 PECOS PAC ID: 4880845395 Enrollment ID: I20200505001749  | 
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